{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:22:18Z","timestamp":1787840538955,"version":"build-2784847793"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Ocular syphilis is a significant manifestation of neurosyphilis that can occur at any stage of syphilis infection and may affect one or both eyes. The most common symptoms include reduced vision, pain, photophobia, and flashes of light. Uveitis and otic neuropathies are frequently observed ocular manifestations. If left untreated, ocular syphilis can result in permanent vision loss, highlighting the importance of thorough evaluation and timely treatment. We present the case of a 44-year-old woman, who exhibited symptoms including a maculopapular rash on the trunk and upper limbs, followed by cervical lymphadenopathy, tonsillitis, and decreased vision. Serological tests showed positivity for Venereal Disease Research Laboratory (1:32) and\n                    <jats:italic toggle=\"yes\">Treponema pallidum<\/jats:italic>\n                    haemagglutination (1:10,240). An magnetic resonance imaging of the brain ruled out any pathological intracranial impregnations. Analysis of the cerebrospinal fluid revealed normal cellularity. An ocular ultrasound and a Doppler examination of the ophthalmic artery were conducted to assess the Ocular Assessment Rating Index (OARI). A retinal detachment was observed in the right eye, showing a significant increase in OARI compared to the left eye (0.82 vs. 0.68). A clinically significant increase in OARI was defined as a value &gt;0.75 based on previous observations. The patient was treated with aqueous crystalline penicillin G for 10 days. This case highlights a potential link between damage to the ophthalmic and cerebral vascular systems and systemic manifestations in early syphilis. We propose that Doppler of the ophthalmic artery, with resistance index calculation, should be part of the diagnostic evaluation for patients with syphilis. An increased OARI may identify patients who should undergo lumbar puncture to confirm a diagnosis of neurosyphilis and initiate appropriate therapy.\n                  <\/jats:p>","DOI":"10.4103\/ijstd.ijstd_139_24","type":"journal-article","created":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T06:00:31Z","timestamp":1749448831000},"page":"66-68","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Secondary syphilis presenting with increased ophthalmic artery resistance index: A case report"],"prefix":"10.4103","volume":"46","author":[{"given":"Pierfrancesco","family":"Grima","sequence":"first","affiliation":[{"name":"Infectious Diseases Unit, Vito Fazzi Hospital, Lecce, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Guido","sequence":"additional","affiliation":[{"name":"Department of Biological and Environmental Sciences and Technologies, Laboratory of Hygiene, University of Salento, Lecce, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaella","family":"Sedile","sequence":"additional","affiliation":[{"name":"Institute of Clinical Physiology, National Research Council, Lecce, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Zizza","sequence":"additional","affiliation":[{"name":"Institute of Clinical Physiology, National Research Council, Lecce, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,6,9]]},"reference":[{"key":"R3-20250617","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1056\/NEJMra1901593","article-title":"The modern epidemic of syphilis","volume":"382","author":"Ghanem","year":"2020","journal-title":"N Engl J Med"},{"key":"R4-20250617","doi-asserted-by":"crossref","first-page":"e57","DOI":"10.1093\/cid\/ciad437","article-title":"State-of-the-art review:Neurosyphilis","volume":"78","author":"Hamill","year":"2024","journal-title":"Clin Infect Dis"},{"key":"R5-20250617","doi-asserted-by":"crossref","first-page":"855","DOI":"10.7326\/0003-4819-109-11-855","article-title":"Invasion of the central nervous system by Treponema pallidum:Implications for diagnosis and treatment","volume":"109","author":"Lukehart","year":"1988","journal-title":"Ann Intern Med"},{"key":"R6-20250617","doi-asserted-by":"crossref","first-page":"1358","DOI":"10.1056\/NEJMra1906228","article-title":"Neurosyphilis","volume":"381","author":"Ropper","year":"2019","journal-title":"N Engl J Med"},{"key":"R7-20250617","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1016\/j.medmal.2020.10.016","article-title":"Early symptomatic neurosyphilis and ocular syphilis:A comparative study between HIV-positive and HIV-negative patients","volume":"51","author":"Rasoldier","year":"2021","journal-title":"Infect Dis Now"},{"key":"R8-20250617","doi-asserted-by":"crossref","first-page":"2337","DOI":"10.1038\/s41433-024-03150-w","article-title":"Ocular versus neurosyphilis. Are they the same?","volume":"38","author":"Reid","year":"2024","journal-title":"A guide to investigation and management. Eye (Lond)"},{"key":"R9-20250617","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1136\/practneurol-2020-002629","article-title":"Neuroretinitis:A tricky mimic","volume":"20","author":"Lueck","year":"2020","journal-title":"Pract Neurol"},{"key":"R10-20250617","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1097\/OLQ.0b013e31824c0e62","article-title":"The performance of cerebrospinal fluid treponemal-specific antibody tests in neurosyphilis:A systematic review","volume":"39","author":"Harding","year":"2012","journal-title":"Sex Transm Dis"},{"key":"R11-20250617","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1080\/09273948.2018.1521436","article-title":"Clinical manifestations and cerebrospinal fluid status in ocular syphilis","volume":"27","author":"Lapere","year":"2019","journal-title":"Ocul Immunol Inflamm"},{"key":"R12-20250617","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.jcjo.2019.05.009","article-title":"Ocular syphilis:Case series (2000-2015) from 2 tertiary care centres in Montreal, Canada","volume":"55","author":"Vadboncoeur","year":"2020","journal-title":"Can J Ophthalmol"},{"key":"R13-20250617","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1111\/j.1468-1293.2005.00324.x","article-title":"Carotid intima-media thickness is slightly increased over time in HIV-1-infected patients","volume":"6","author":"Merci\u00e9","year":"2005","journal-title":"HIV Med"},{"key":"R14-20250617","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1002\/jcu.20664","article-title":"Sonographically measured perirenal fat thickness:An early predictor of atherosclerosis in HIV-1-infected patients receiving highly active antiretroviral therapy?","volume":"38","author":"Grima","year":"2010","journal-title":"J Clin Ultrasound"},{"key":"R15-20250617","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1111\/jdv.16946","article-title":"2020 European guideline on the management of syphilis","volume":"35","author":"Janier","year":"2021","journal-title":"J Eur Acad Dermatol Venereol"}],"container-title":["Indian Journal of Sexually Transmitted Diseases and AIDS"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijstd.ijstd_139_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:24:40Z","timestamp":1787837080000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijstd.ijstd_139_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":13,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/ijstd.ijstd_139_24","relation":{},"ISSN":["2589-0557","2589-0565"],"issn-type":[{"value":"2589-0557","type":"print"},{"value":"2589-0565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2024-11-15","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-24","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}